Scientific Program

Conference Series Ltd invites all the participants across the globe to attend International Conference on Pediatric Pharmacology and Therapeutics Toronto, Ontario, Canada.

Day 2 :

OMICS International Pediatric Pharma 2018 International Conference Keynote Speaker Sherwin Morgan photo
Biography:

Sherwin Morgan completed his respiratory care training from Malcolm X College of Respiratory Care in Chicago, IL. He is an advanced respiratory care practitioner with the National Board for Respiratory Care in the United States. He is Clinical Practice and Development /Educator/Research Coordinator for the Department of Respiratory Care Services, Section of Pulmonary and Critical Care Medicine at the University of Chicago Medicine. He has published more than 25 peer review papers in multiple medical journals. He has designed, engineered, and collaborated with a number of research studies with the pulmonary medicine department.

Abstract:

Introduction: Th e global gold standard for delivering aerosolized medication to infants in respiratory distress has been via the Small Volume Jet Nebulizer (SVJN) with a face mask. The medication most commonly used is albuterol 0.083%. During the procedure, a parent must hold the mask on the babyface, which can make the child combative. Therefore, the standard oxygen treatment is moving from face mask to High Flow Nasal cannula (HFNC) in conjunction with aerosolized beta-agonist treatments. A recent study of aerosol drug distribution using a face mask with TC99 label albuterol demonstrated that < less than 1% of the aerosol drug reached the lung and deposition was even less when the infant was crying or upset. Medication delivery is decreased even more when the patient has a nasal cannula in their nose and a pacifi er in their mouth. Children are mostly nasal breathers. In vitro pediatric lung model studies with the combination of HFNC&ANB, estimated aerosol deposition at 18 to 26%, although effi cacy is low, it is enough to exert a clinical eff ect when the treatment process was changed to delivery via HFNC and the vibrating mesh nebulizer (Aerogen® Solo Nebulizer), there was improvement with patient and parent comfort levels. Most children were calm and able to sleep throughout the treatment, keep the pacifi ers in and some were able to breastfeed during treatment. The clinical indicator that there was better aerosol medication deposition was that many kids experienced an increased heart rate of 10 to 15% from baseline, although they were not being touched or stimulated.
Bedside clinician could see medication aerosol exhalation around the pacifiers.
 
Conclusion: This development has revolutionized aerosolized inhaled medication delivery with the ultra-sonic vibrating mesh nebulizer for infants in respiratory distress. More study is needed in this area.

Keynote Forum

Mir Anwar

Richmond Chest Hospital, South Africa

Keynote: Malnutrition in children- South Africa’s present scenario

Time : 09:40-10:20

OMICS International Pediatric Pharma 2018 International Conference Keynote Speaker Mir Anwar photo
Biography:

Mir N Anwar graduated in Medicine from Bangladesh in 1975. He did his Post-graduation in Pediatrics from Ireland in 1982. He did his MPH concentration Maternity and Child Health from University of Massachusetts, USA in 2003. Then he joined UN/ WHO and worked as a Pediatric Consultant & Public Health Specialist, around the world including Asia, Japan, Middle East, Africa, Pacifi c Island, Ireland and USA. Since 2007 he has been working in South Africa in different provinces of South Africa with the Department of Health. Presently he is working as a Clinical Medical Manager in Richmond Chest Hospital, KZN. South Africa. Presently his main interest is in Childhood TB and HIV in Sub-Saharan Africa. In his long carrier in Pediatric and Public Health he attended several international congress, conferences, and seminars and presented his original work. Some of them were published in International Journal including American Child Neurology Journal, Japan Pediatric Neurology Journal, Pakistan Pediatric Journal, Bangladesh Child Medical Journal, Nigerian Journal of Obstetrics and Gynaecology etc. For his work he is honoured by American Academy of Pediatrics, Royal College of Health, UK, and International College of Pediatrics. His biography is published in Who’s Who in Medicine Cambridge, UK in 1985.

Abstract:

Malnutrition occurs when an individual’s dietary intake is not balanced with nutritional needs. More than 75% of the children admitted in Public Hospital of sub-saharan Africa for any reason are suffering from malnutrition. Department of Health of South Africa publish that 15% of South African infants are born with a low birth weight. Th ere are 25% of pre-school children and 20% of primary school children in South Africa suff ered from malnutrition. Since 2011 to 2016 over the period of 6 years we followed total paediatric admission in Stanger Hospital, Natal Province, South Africa. Average annual admission is around 1400-1500 (excluding neonates) in paediatric wards, Around 9000 over last six years, female child are predominant, female and male ratio was found 60:40. Lack of breast feeding is also a cause for the malnutrition. The 2010 South Africa department of Health Study found that 30.2% of pregnant women in South Africa have HIV/AIDS and they are reluctant to breast feed their children. Malnutrition is the cause of severe poverty in sub –sharan Africa. According to statistics from the year 2000, 50% of the South African population is under the poverty line. Th e World Health Organization showed that over the span of thirteen years (1995 to 2008), the deviation from the average height of children under age fi ve in South Africa has decreased from 28.7% to 23.9%. Th e approac

Keynote Forum

Kaye Talijancich

Princess Margaret Hospital for Children, Australia

Keynote: The role of laser in tongue tie division: A pilot study

Time : 09:40-10:20

OMICS International Pediatric Pharma 2018 International Conference Keynote Speaker Kaye Talijancich photo
Biography:

Kaye studied Bachelor of Science – Nursing, at Curtin University and graduated as a Registered Nurse in 2008. She currently works as Registered Nurse (parttime) looking after babies under 28 days at Neonatal Department at Princess Margaret Hospital for Children, Subiaco, Perth (WA). Her previous paediatric nursing experience includes working at the Emergency Department, Gastroenterology and Immunology Departments at Princess Margaret Hospital for Children. She has also worked for Edith Cowan University as a Paediatric Clinical Facilitator. Kaye commenced at Perth Paediatrics in 2016. She brings her skills and dedicated passion of working with children, to the fi rst multi-specialty private paediatric clinic in Western Australia.

Abstract:

Background: Laser tongue tie division is an option suitable for neonates, older children, and adults. No general anesthetic is used, but an analgesic gel is applied. Th e procedure is very quick, taking only 2 to 3 minutes to perform.
 
Aim: To assess the outcome of patients who underwent tongue tie division with Diode Laser at Perth Paediatric.
 
Methods: We conducted a retrospective review of the 49 children who underwent laser repair of tongue tie at Perth Paediatrics between 30/01/2017 and 10/7/2017. Th e age of the children ranged from 4 days to 6 months. We assessed the outcome aft er 1 to 6 months, with a questionnaire via telephone. Of the 49 children’s mothers telephoned, a total of 41 children were contactable. The outcome was assessed in terms of improvement of breastfeeding comfort to the mother and procedural complications.
 
Results: The outcome was assessed in terms of improvement in breastfeeding and lack of discomfort. 41 mums had immediate relief, which was rated good to excellent. 3 mums had poor immediate relief but there was an improvement aft er 2 weeks of procedure and was rated good. Only 2 out of 41 mothers reported no relief in improvement in breastfeeding. Furthermore, it was noted that refl ux symptoms in 3 children decreased post laser treatment and a weight gain increase was noted. There were no immediate or delayed procedural complications in terms of post-operative bleeding, infection, scarring or recurrence.
 
Conclusion: 95.2% (39/41) of children, who underwent tongue tie division with laser, were reported by their mothers, to have improvement in breastfeeding improvement in terms of latch/leakage. This outcome also included an improvement in the mother’s discomfort. Ie. nipple pain, nipple damage, and mastitis.

Keynote Forum

Christina YK Leung

University of Hong Kong, China

Keynote: Drugs use in Biliary atresia and the roles of clinical pharmacist

Time : 11:15-12:55

OMICS International Pediatric Pharma 2018 International Conference Keynote Speaker Christina YK Leung photo
Biography:

Christina Leung completed two Bachelor degrees in England, BSc Management Sciences followed by the BPharm Pharmacy. Following the registration as a pharmacist in the UK, she worked in different London Teaching Hospitals for 16 years. In UK, she specialised in Paediatrics (especially in PICU and Paediatric Liver), Obstetrics and Gynaecology. She published a number of articles including drugs use in paediatric liver diseases in the UK and management of vomiting in pregnancy and hyperemesis gravidarum. Ms Leung is also a registered pharmacist in Hong Kong. Since 2012, she had worked as the Senior Pharmacist (Clinical Pharmacy in Charge) at the University of Hong Kong-Shenzhen Hospital, a reformed hospital in China. Currently, Ms Leung is the Honorary Tutor at the University of Hong Kong. She delivers lectures to the Master and Undergraduate Pharmacy students relating to drugs use in Paediatrics, Obstetrics and Gynaecology.

Abstract:

Biliary atresia (BA) is a condition in which inflammation develops within the bile ducts around the time of birth. Th is leads to bile duct damage and reduces the flow of the bile which subsequently causes scarring of the liver. Th e initial treatment for biliary atresia is a surgical operation called the “Kasai Porteoenterostomy” (KPE). Th e aim of KPE is to make a drainage channel to allow bile to drain from the liver. Before the surgery, the patient will be prescribed with fat-soluble vitamins for patients with prolonged jaundice. Examples are multivitamin preparations (Abidec® or Dalivit® drops in the UK), vitamin K preparations (phytomenadione injection which can be given by oral, IV or IM routes and menadiol tablet), Vitamin E (tocopheryl acetate), and Vitamin D (Alfacalcidol). 24 to 48 hours before the surgery, the patients will receive bowel preparations and the common ones are Lactulose liquid, Neomycin liquid, and Metronidazole suspension. After the operation, the patient will receive drugs via intravenous or intramuscular route for about 3 to 5 days, standard maintenance IV fluid will be given for about 3 to 4 days. Nurse Controlled Analgesia (NCA) IV pump with morphine is always used for the initial 3 days, and the patient is also prescribed with regular paracetamol (IV or rectal) for breakthrough pain for about 3 days then change to oral. Prophylactic IV antibiotics will be given after the surgery for at least 72 hours. Examples are Gentamicin and Piperacillin/Tazobactam as dual therapies. After 72 hours, if no high temperature is developed and the oral feeds are started, the prophylactic antibiotics can be changed to oral for 28 days (an example is oral Cefalexin). Ranitidine is also used to prevent a stress-induced ulcer. Intramuscular vitamins are used post-surgery. Examples are Vitamin D 30,000 units (60,000 units if radiological rickets is present), Vitamin E 10mg per kg, Vitamin A 10,000 units are given at the discretion of hepatologist (usually for patients with late diagnosis). After day 5 of operations, the patient may start oral therapies. Additional oral vitamins are necessary post-surgery for about 6 months. Examples are Vitamin K, Vitamin E, and multivitamin drops. Oral Phenobarbitone (alcohol-free liquid or tablet) helps to increase bile fl ow and hence to reduce itching symptom. Th e recommended dose is 15mg daily, increasing to 45mg daily in steps of 15mg per week. Colestyramine helps to remove the bile salts which cause jaundice and itchiness. Since Colestyramine can reduce the absorption of some drugs, especially vitamins, it is recommended to leave vitamin preparations at least 2 hours before or 4 hours after giving Colestyramine. Spironolactone suspension helps the patient reduces the amount of fluid accumulated as a result of ascites, but it is not needed in all cases. Th ere have been clinical studies to use high dose oral steroids (oral prednisolone) post KPE to benefit in reduction of postoperative bilirubin and clearance of jaundice. However, the findings show that the effect of steroids may be limited or inhibited by an increasing degree of fibrosis and onset of cirrhosis. If KPE is successful, many of these medicines can be stopped over time. If KPE fails, the liver transplant can be one of the treatment options. Th e care of the biliary atresia patients is best with the multi-disciplinary approach, and clinical pharmacists play a significant role in this care management. Examples of the contributions are dosage recommendations, choice of drugs, stopping or initiation of a therapy, guidelines development, drug history talking and medication reconciliation, therapeutic drug monitoring and other blood results monitoring to optimize drug therapies, patient education such as developing of patient leaflets and delivering of patient education talks, patient counselling of discharged medications such as using of tailored-made discharge medication card, discharge planning to reduce the waiting time, adverse drugs reactions monitoring, medication incidents management, drugs interactions, advice on drug administration (e.g. with or after food, timing of drug administration, method of IV drug administration), review of medications in the out-patient clinics after discharge, and participation in the clinical trials.